Old age population has increased and the family support is on the decline. The urbanisation of societies and constrained resources of families are seen as reason for the decline in family support. However formal social insurance is also known to give elders social and economic protection as well as better living arrangements in the future. The study examines how health insurance in old age affects family support for elders. Six cases studies were used to examine the relationship between health insurance as structure and elders as agents. Interviews and observation of informants were used as techniques to gather information. The case study observed that elders have reduced their dependence on family support. Less dependence on the family support was observed among insured elders. This does not mean the importance of the family is reduced. The declining dependence on family support is due to the complementary roles of healthcare provided through health insurance which influences interaction between the elders and their dependence on family support.